The United States lacks a consensus over the economic, environmental, health and social implications of the rapidly expanding use of high-volume horizontal hydraulic fracturing (HVHF) in both unconventional and conventional oil and gas development (this includes shale gas). Although these operations have been employed for over a decade in some states, and much controversy exists about the effects of these operations on the environment and public health, there is a dearth of studies measuring community impacts. In addition, there exists very little empirical guidance on the use of lease terms involving environmental protections (e.g. compressor station restrictions, surface damage remediation) and health-related protections, both of which are potential mechanisms for sheltering homeowners from the potential costs of shale gas development. Negotiated lease terms could depend upon the characteristics of homeowners, such that individuals who do not have negotiation power sign inferior lease terms. Subsequently, such inequities in lease terms could be a significant source of variation in health outcomes resulting from living in close proximity to shale gas development, with the most vulnerable populations experiencing the largest burden on health. The long-term goal is to build a research agenda that seeks to broadly understand the trade-offs (e.g. increased economic activity versus increased environmental degradation or harm to public health) that are facing policymakers and community members with respect to energy production, as well as the implications for public health and environmental health policy. The objective is to comprehensively study the effect of shale gas development on infant and child health outcomes and to identify health-protective lease terms. The proposed research aims to: 1) measure how air emissions from operations contribute to childhood respiratory disease exacerbations and incidence; 2) estimate how drinking water contamination from shale waste affects pregnancy outcomes and drinking water violations; 3) investigate how lease clauses modify previously measured adverse pregnancy outcomes, and how leasing clauses and royalties depend on socio-demographic contexts. The approach is innovative because it uses econometric techniques to exploit both temporal and spatial quasi-random variation across sites that are otherwise uniform, thereby allowing for quantifying differences in health associated uniquely with operations while holding other individual and community characteristics constant. The proposed research is significant because the findings will guide both the future research of specific pollutant pathways as well as policymakers and individual mineral rights owners about how to enhance the economic benefits and diminish any measured risks of shale gas development.